Cardiac myxoma

A cardiac myxoma is an abnormal mass that develops inside the heart. It is considered a benign tumor, meaning it is not cancer and does not spread to other organs as malignant tumors can.

However, because the heart is an essential pump responsible for circulating bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood throughout the body, any mass developing within it can interfere with its function. For this reason, even though a myxoma is benign, it must always be taken seriously.

Where is a myxoma usually located?

In the vast majority of cases, a myxoma develops in the left atrium, one of the heart’s upper chambers. It is most often attached to the inner wall of the heart at the level of the interatrial septum, the partition that separates the two atriaThe atria are the two upper chambers of the heart. They act as reservoirs for blood that will fill the ventricles..

This area represents a common point of attachment for a myxoma. From there, the mass may move within the atrium with each heartbeat. This mobility helps explain why some symptoms can vary depending on body position or appear intermittently.

More rarely, a myxoma may form elsewhere in the heart. Its exact location then plays an important role in the symptoms observed and the associated risks.

A generally slow, but unpredictable growth

A cardiac myxoma does not develop overnight. In most cases, it grows slowly and progressively, over several months or even years. This gradual evolution explains why it may remain silent for a long time and be discovered incidentally during an examination performed for another reason.

However, even though its growth is usually slow, a myxoma remains unpredictable. Depending on its size, shape, and especially its mobility, symptoms may appear relatively quickly, without being directly related to the actual speed of growth. A small but highly mobile mass can sometimes cause significant manifestations.

It is this combination of gradual growth and the risk of sudden complications that justifies surgical treatment as soon as the diagnosis is made, even in the absence of marked symptoms.

What does a myxoma look like?

A myxoma is not a hard mass. Its texture is often described as soft or gelatinous. It is usually attached to the inner wall of the heart by a pedicle, a small point of attachment, almost as if it were suspended.

With each heartbeat, the mass may move within the chamber. This motion explains why certain symptoms can appear suddenly or vary depending on body position.

Why can a myxoma cause problems?

The heart functions as a system of doors and passageways that open and close with every beat. When a myxoma is present, it can sometimes interfere with this normal mechanism.

Depending on its size and position, it may partially obstruct bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flow, particularly at the level of a valve. BloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood then circulates less easily, which can lead to shortness of breath or unusual fatigue.

Another risk comes from the fact that small fragments of the myxoma may break off. These fragments can travel through the bloodstream and block an artery elsewhere in the body, especially in the brain. This is known as an embolism.

What symptoms can a myxoma cause?

The manifestations of a myxoma are highly variable. Some individuals experience significant symptoms, while others may have none for a long time.

When the mass interferes with bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood flow inside the heart, symptoms such as shortness of breath during exertion, fatigue, or dizziness may occur. In some cases, fainting episodes can develop.

If fragments break off, the symptoms depend on the organ affected. When the brain is involved, sudden neurological signs may appear, such as a stroke.

A myxoma may also be associated with more general symptoms, including persistent fever or an unexplained feeling of malaise. These nonspecific signs can sometimes delay the diagnosis.

How is the diagnosis made?

A myxoma is most often discovered through echocardiography, a simple and painless ultrasound examination. This test allows direct visualization of the inside of the heart and can identify the presence of a mobile mass.

In certain situations, additional imaging studies may be used to better define the size, shape, or exact location of the myxoma, especially when planning surgery.

What is the treatment?

Treatment of a myxoma is primarily surgical. It consists of completely removing the mass in order to eliminate the risk of obstruction and embolism.

This procedure usually requires open-heart surgery, which involves opening the chest to access the heart directly and remove the tumor in a complete and safe manner. This approach allows the surgeon to clearly visualize the point of attachment of the myxoma and ensure that it is entirely removed.

This step can be compared to removing a weed: to prevent it from growing back, it is not enough to remove only what is visible.

The tumor must be excised along with its attachment site, including a small margin of healthy tissue, in order to minimize the risk of recurrence.

Although the word “surgery” may sound concerning, this is a well-established procedure that has been performed for many years. In the vast majority of cases, outcomes are excellent. Once the myxoma has been removed, the heart can generally return to normal function.

What happens after the operation?

After surgery, follow-up care is put in place, most often with regular echocardiograms. This monitoring ensures that the heart is functioning well and that no new mass appears.

Risk of recurrence and follow-up after surgery

Once the myxoma has been surgically removed, the outcome is most often very favorable. In the vast majority of cases, the tumor does not return and the heart regains normal function.

Studies show that recurrence of a cardiac myxoma remains rare, affecting only a small proportion of operated patients. The risk is particularly low when the tumor is solitary and has been completely removed during the first procedure.

Despite this very reassuring prognosis, regular follow-up with echocardiography is usually recommended after surgery. This follow-up is part of a cautious and preventive approach. It allows physicians to confirm that everything remains normal over time, often well before any symptom could appear.

It is important to understand that this surveillance does not mean recurrence is expected. Rather, it aims to support the individual over the long term and provide peace of mind, both for the patient and the medical team.

In the vast majority of situations, individuals who have undergone surgery for a myxoma return to their usual activities and lead a fully normal life.

Familial forms: a rarer situation

In rare cases, cardiac myxoma occurs in a familial or genetic context. These forms often appear earlier in life and may affect several members of the same family.

When such a situation is suspected or confirmed, follow-up is adapted accordingly. Closer monitoring may then be implemented, not only for the affected individual but sometimes also for certain family members, in order to detect any abnormality at an early stage.